Harvard Medical School Family Health Guide

by Harvard Medical School

• ISBN13: 9780684847030
• ISBN10: 0684847035
• Format: Hardcover
• Copyright: 1999-10-07
• Publisher: Free Press

Summary

The first health guide for the era of managed care is also the only one that will never go out of date. www.health.harvard.edu/fhg offers page and index searches for updated information on every entry. Today we all have a better chance of living a longer, healthier life than ever before -- but only if we know how to utilize the advances in medicine science has given us. Whether you depend on traditional fee-for-service health care or some form of managed care, you must make health decisions in partnership with doctors...doctors with whom you may only spend a few minutes. How can you sort out the confusing, often contradictory health information that is bombarding you daily and communicate clearly and effectively with your doctor? How can you gain access to the best care and evaluate the care you are getting? The Harvard Medical School Family Health Guide answers these essential questions and many more. The first health guide written specifically to empower readers in the era of managed care, it is the culmination of 200 years of clinical care, health education, and medical research -- bringing you the expertise of more than 7,000 health professionals from some of the nation's most esteemed hospitals and research centers. In this book, they have gathered the most authoritative, comprehensive, easy-to-understand, up-to-the-minute information about the diagnosis, treatment, and prevention of disease in every stage of life to help you:

• Make the most of the time you spend with your doctor.
• Decide when and if you need to see a doctor.
• Avoid dangerous drug interactions.
• Explore alternative treatments safely.
• Choose wisely among treatment options.
• Access emergency and other important information easily.
• Learn the most effective ways to prevent disease.
• Consult with the most renowned doctors in America, including Herbert Benson, T. Berry Brazelton, Robert Coles, and Richard Ferber.
• Receive the most current information from our Web site, which gives you free online updates.

Harvard Medical School consists of world-renowned affiliated hospitals, clinics, and research foundations, which include:
Beth Israel Deaconess Medical Center • Brigham and Women's Hospital* • Cambridge Hospital • Center for Blood Research • Children's Hospital* • Dana Farber Cancer Institute • Harvard Pilgrim Health Care • Joslin Diabetes Center* • Judge Baker Children's Center • Massachusetts Eye and Ear Infirmary • Massachusetts General Hospital* • Massachusetts Mental Health Center • McLean Hospital • Mount Auburn Hospital • Schepens Eye Research Institute • Spaulding Rehabilitation Hospital • VA Boston Healthcare System (*CONSISTENTLY RANKED AMONG THE 10 BEST HEALTH INSTITUTIONS IN THE UNITED STATES) Throughout its history, Harvard's doctors have made important medical breakthroughs, including: the discovery of anesthesia • the birth of brain surgery • the first human organ transplantation (Nobel Prize) • the discovery of the polio virus (Nobel Prize) • the discovery of vitamin B12 as the cure for pernicious anemia (Nobel Prize) • the discovery of how the human eye sees (Nobel Prize) • the discovery of the aspirin-a-day prevention strategy for heart disease

Author Biography

Medical Editor Anthony L. Komaroff, MD, is Professor of Medicine at Harvard Medical School, Senior Physician at Brigham and Women's Hospital in Boston, and Editor in Chief of Harvard Health Publications.

Table of Contents

Foreword	8	(9)
Navigating the Health Care System	17	(14)
Take Charge of Your Health	31	(66)
How to Stay Healthy	31	(8)
Diet and Nutrition	39	(12)
Exercise and Fitness	51	(6)
Using Addictive Substances	57	(12)
Contraception and Safer Sex	69	(9)
Medical Checkups and Screening Tests	78	(8)
Safety and Preventing Injury	86	(4)
Stress	90	(2)
Preventing Infection	92	(2)
Immunizations and Travel Health	94	(3)
How Your Body Works	97	(24)
How you Read and Remember	97	(1)
How you speak and Understand Speech	98	(1)
How you Recognize Objects	99	(1)
How you See	100	(1)
How you Hear	101	(1)
How you Feel Pain	102	(1)
How you smell and Taste	103	(1)
How you move	104	(2)
Your Vital Functions and the Autonomic Nervous System	106	(2)
How you Circulate Blood	108	(1)
How you Make Blood	109	(1)
Hwo you Breathe	110	(1)
How Hormones work	111	(1)
How you Digest	112	(2)
How you Eliminate Wastes and Keep Fluids in Balance	114	(1)
How you Kidneys Work	115	(1)
How you Reproduce	116	(2)
How you Fight Bacterial Infections	118	(1)
How you Fight Viral Infections	119	(1)
How you Heal Injuries	120	(1)
Diagnosing Disease	121	(50)
You and Your Doctor	121	(5)
Understanding Genetics	126	(9)
Guide to Imaging	135	(18)
Diagnostic Tests	153	(10)
Going to the Hospital	163	(8)
Symptom Charts	171	(166)
How to use the Symptom charts	171	(1)
General Symptoms	172	(94)
Women's symptoms	266	(27)
Symptoms of Infants and Children	293	(37)
Men's symptoms	330	(7)
Brain and Nervous System	337	(54)
Stroke	342	(12)
Headache	354	(3)
Cancer	357	(2)
Injuries	359	(3)
Thinking Disorders	362	(6)
Other Degenerative Diseases	368	(5)
Other Nervous System Disorders	373	(10)
Sleep and Sleep Problems	383	(8)
Behavioral and Emotional Disorders	391	(24)
Treatment	392	(1)
Types of Theraphy	393	(2)
Mood and Anxiety Disroders	395	(12)
Personality Disorders	407	(2)
Psychoses	409	(2)
Other Behavioral and Emotional Disorders	411	(4)
Eyes	415	(32)
Eyelids	418	(2)
Focusing Problems	420	(7)
Outer Surfeace of the Eye	427	(3)
Inside the Eye	430	(15)
Other Eye Conditions	445	(2)
Ears, Nose, and Throat	447	(22)
Ears	449	(11)
Nose	460	(6)
Throat	466	(3)
Teeth, Mouth, and Gums	469	(25)
Preventing Tooth Decay and Plaque	470	(4)
Common Dental Problems	474	(5)
Common Dental Procedures	479	(6)
Dental Injuries	485	(1)
Cosmetic Improvement of Teeth	486	(1)
Sores of the Mouth, Lip, and Tongue	487	(2)
Cancerous and Precancerous Conditions of the Mouth	489	(1)
Tongue Variations	490	(1)
Problems of the Salivary Glands	491	(3)
Lungs	494	(33)
Infections	494	(11)
Asthma	505	(18)
Lung Cancer	523	(4)
Skin, Hair, and Nails	527	(34)
Skin	529	(26)
Hair	555	(3)
Nails	558	(3)
Color Guide to Visual Diagnosis	561	(8)
Fungal Infections	561	(1)
Bacterial Infections	562	(1)
Other Important Skin Conditions	562	(2)
Noncancerous (Benign) Growths	564	(1)
Precancerous Growths	564	(1)
Cancerous (Malignant) Growths	565	(1)
Infestations with Insects	566	(1)
Scaling and Itching Conditions	566	(1)
Injuries	567	(1)
Hair Loss for Unknown Reasons	567	(1)
Infections of the Nails	567	(1)
Disorders of the Mouth	567	(1)
Disorders of the Eyes and Eyelids	567	(1)
Common Childhood Diseases	568	(1)
Cosmetic and Reconstructive Surgery	569	(22)
Breasts	572	(3)
Face	575	(6)
Skin	581	(7)
Body Shaping	588	(3)
Bones, Joints, and Muscles	591	(50)
Bones	593	(8)
Joints	601	(9)
Muscles, Tendons, and Ligaments	610	(2)
Neck, Shoulders, Arms, and Hands	612	(6)
Back, Hips, Legs, and Feet	618	(23)
Heart, Blood Vessels, and Circulation	641	(68)
Blood Pressure	643	(9)
Disease of the Heart's Arteries: Coronary Artery Disease	652	(19)
Abnormal Heart Rate and Rhythm	671	(10)
Diseases of the Heart Musical and Lining	681	(8)
Diseases of the Heart Valves	689	(9)
Disease of the Arteries and veins	698	(11)
Blood Disorders	709	(34)
Blood Donation and Transfusion	711	(2)
Anemia	713	(11)
Cancers of the Blood Cells (Leukemias)	724	(3)
Cancers of the Lymph Glands (Lymphomas)	727	(7)
Other Blood Disorders	734	(4)
Cancer	738	(5)
Digestive System	743	(60)
Esophagus	746	(6)
Stomach	752	(6)
Liver	758	(10)
Pancreas	768	(2)
Gallbladder and Bile Ducts	770	(4)
Small Intestine	774	(4)
Diarrheal Diseases and Disorders	778	(3)
Large Intestine	781	(13)
Rectal And Anal Disorders	794	(4)
Other Gastrointestinal Tract Disorders	798	(5)
Urinary System	803	(26)
Urinary Tract Infection and Inflammation	804	(6)
Kidney Disease and Kidney Failure	810	(12)
Cancer	822	(2)
Other Urinary Tract Disorders	824	(5)
Hormonal Disorders	829	(34)
Diabetes	832	(12)
Thyroid Gland Disorders	844	(8)
Parathyroid Gland Disorders	852	(1)
Metabolic Disorders	853	(3)
Adrenal Gland Disorders	856	(3)
Pituitary Gland Disorders	859	(2)
Superhormones	861	(2)
Infections and Immune System Diseases	863	(40)
Infections	871	(23)
Immune System Diseases	894	(9)
Infertility, Pregnancy, and Childbirth	903	(42)
Infertility	904	(10)
Pregnancy	914	(9)
Common Discomforts of Pregnancy	923	(5)
Serious Conditions Of Pregnancy	928	(7)
Childbirth	935	(10)
Health of Infants and Children	945	(76)
Immunizations and the Diseases They Prevent	946	(5)
Health and Development of Children Younger Than Age 2	951	(36)
Health and Development of Children Older Than Age 2	987	(34)
Health of Adolescents	1021	(18)
For Parents: Knowing Your Adolescent Child	1021	(4)
For Teens: Knowing Yourself	1025	(14)
Health of Women	1039	(46)
A Woman's Reproductive System	1039	(2)
Tests Women May Have	1041	(2)
Menstruation	1043	(4)
Menopause	1047	(6)
Breasts	1053	(10)
Vulva	1063	(1)
Vagina	1064	(2)
Cervix	1066	(4)
Uterus	1070	(6)
Ovaries and Fallopian Tubes	1076	(5)
Sexuality	1081	(1)
Problems With Female Sexual Function	1081	(2)
Women and Violence	1083	(2)
Health of Men	1085	(26)
Penis	1086	(2)
Testicles and Scrotum	1088	(2)
Sexuality	1090	(1)
Problems With Male Sexual Function	1091	(4)
Prostate Gland	1095	(15)
The Aging Male	1110	(1)
Health of Seniors	1111	(8)
Strength Training For Seniors	1112	(1)
How Our Senses Change With Age	1113	(1)
Health Issues of Older Adults	1113	(6)
Caregiving and Eldercare	1119	(18)
Caregiving In Your Home	1119	(10)
Support Systems	1129	(3)
Living Arrangements	1132	(3)
Caregiving For A Person With Alzheimer Disease Or Other Dementia	1135	(2)
Death and Dying	1137	(10)
Issues At The End of Life	1138	(4)
Putting Affairs in Order	1142	(1)
After Death	1143	(4)
Medicines	1147	(42)
The Basics	1147	(4)
Safety	1151	(5)
Managing Your Medicines	1156	(3)
Common Drug Classes	1159	(3)
Drug Index	1162	(4)
Drug Interactions Chart	1166	(23)
First Aid and Emergency Care	1189	(28)
Emergency Care: A to Z	1190	(27)
Replaceable Parts of Irreplaceable You	1217	(3)
Appendix	1220	(29)
Medical Terminology	1220	(7)
Glossary	1220	(7)
Board-Certified Medical Specialists	1227	(1)
Information Resources	1227	(15)
Diseases, Conditions, and Issues: Private Organizations	1227	(10)
Diseases, Conditions, and Issues: Federal Agencies	1237	(1)
Medical Internet Resources	1238	(1)
National Cancer Institute-Designated Cancer Centers	1238	(1)
Poison Control Center	1238	(4)
Medical Forms and Charts	1242	(7)
Living Wills	1242	(3)
Medical Records Summary	1245	(1)
Type of Activity and Calories Burned	1246	(1)
Calorie, Fiber, and Fat Content of Common Foods	1246	(3)
Index	1249

Excerpts

Excerpt

Foreword: Welcome to the Harvard Medical School Family Health Guide

I am proud to introduce you to the Harvard Medical School Family Health Guide. For more than 200 years, the Harvard Medical School has provided state-of-the-art health care to millions of people from New England and all over the world.

First and foremost, the 7,000 doctors on the faculty take care of patients. Harvard Medical School faculty staff some of the world's most distinguished hospitals and health care systems. We teach our patients how to stay healthy. And every day we are there to care for them when medical problems develop, whether they have a bad cold or need emergency surgery.

We also teach the next generation of doctors and conduct the largest medical research program in the world. At Harvard Medical School:

Anesthesia was discovered. Can you imagine having to undergo major surgery without anesthesia?

The virus that causes polio was discovered, leading to the development of the polio vaccine. If you are over 50, you will remember what it was like to live with the fear that you might be the next victim of polio and paralyzed for the rest of your life.

The cure for pernicious anemia was discovered.

The transplantation of organs was first performed.

The use of the artificial kidney was pioneered.

The field of brain surgery was started. Harvard Medical School today is home to the largest and longest ongoing study of women's health -- the famous Nurses' Health Study -- and three of the largest and longest studies of men's health. We are very proud of what we have done to help people lead longer and healthier lives.

We also make house calls, all over the world. For more than 20 years, Harvard Medical School has been publishing health information for the public in our newsletters. Now we are publishing books.

The members of the faculty who edited this book care for patients every day. We know that people are faced with many confusing choices and with more health information than ever before. We also know that the face-to-face time you have with your doctor can be limited.

This book gives you the latest information -- what you need to know to keep yourself healthy and to cope with illness. It also provides you with the information you need to navigate the sometimes confusing and frustrating world of managed care.

To deal with the world of medicine, you need information that is clear, accurate, easily understandable, and accessible.

This book provides that information, sometimes presented in special features, many of which cannot be found in other books. These features include:

Symptom charts What do you do when you develop a particular symptom, such as sudden pain in your abdomen? Is there a home remedy, valid alternative medicine treatment, or over-the-counter medicine you can get at the drugstore? When do you need to contact the doctor? Along with several other colleagues, about 30 years ago I first developed the idea of outlining medical logic in the form of symptom charts. When you or a member of your family has a new symptom, the logically organized charts in this book will help you determine how you may be able to care for yourself, and when you need to contact the doctor.

Advice for when you visit your doctor Today, more than ever, you need to know what questions to ask your doctor. And you need to know what your doctor should be doing for you. You should be getting the best medical care. For many common illnesses, we provide information about what should happen when you visit your doctor -- what issues you should discuss and what kind of a physical examination and laboratory tests your doctor should perform regularly. Think about and write down questions to discuss with your doctor before your visit. Knowing what to expect when you see your doctor can also help you judge how thorough your care has been. For an example of the kinds of questions to ask, see p.899.

Advice on understanding medicines Your doctor may be too busy to fully explain all about your medicine, its benefits, and its possible side effects. In the chapter Medicines, we describe the major types of medicines that doctors prescribe today, and what they are used for.

Advice on drug-drug interactions The Medicines chapter also has an extensive chart of possible adverse reactions between different drugs. If you are taking more than one medication, you need to know if there might be a dangerous interaction between them.

Home remedies You don't always need a doctor. In this book, we offer home remedies that can give you relief from common cold symptoms. For an example of home remedies for the common cold, see p.461.

Alternative medicine treatments A variety of alternative medicine treatments are being seriously studied at Harvard Medical School and elsewhere, and a number have been found to be beneficial. We present them in this book. Conventional medicine has been too slow to study alternative medicine treatments, some of which have won the confidence of healers and patients for thousands of years; it is wrong to reject them out of hand. Alternative medicine treatments, like new conventional treatments, need to be studied scientifically to determine their benefits and risks. For an example of an alternative treatment for chronic low back pain, see p.620.

Understanding diagnostic tests Modern medicine uses many diagnostic tests. In the section called Diagnostic Tests, we describe what these tests are and what they are used for. In the Guide to Imaging, we show you the most sophisticated tests available. Take a look at the remarkable imaging procedures on p.135 that produce pictures of the inside of your body without causing you pain. We also describe many other tests performed in your doctor's office or that can be performed by you at home.

Benefit and risk-assessment graphs There is so much health information available and, often, more than one treatment for a problem. How do you choose among them? We provide information about the benefits and risks of various diagnostic tests and treatments, and the benefits of adapting certain lifestyle changes designed to preserve your health. This numerical information is provided in easy-to-grasp graphs. An example, showing the benefits and risks of blood-thinning treatment, can be found on p.348.

Advice from Harvard doctors Some of the best doctors on the Harvard Medical School faculty have provided personal words of advice based on their experience -- the advice they give their own patients. For example, take a look at Dr Brazelton's advice on the developmental touchpoints in your young child, Dr Lipson's advice on back surgery, Dr Samuels' advice on preventing strokes, Dr Benson's advice on the relaxation response, and Dr Ferber's advice on helping your young child learn healthy sleep habits.

First-person stories We present the personal statements of people who have suffered from an illness, and sometimes how they have coped with it. For example, author John Updike describes what it is like to live with psoriasis, the actress Patty Duke describes her experience with bipolar disorder, and an anonymous person -- perhaps someone like you -- talks about living with gout.

Advice on understanding how your body works Other books describe how your body is built. We show you how your body works -- in colorful art that clearly depicts how you see, hear, move, digest food, circulate blood, and so forth. To better understand what can go wrong with your body, it is important to understand how your body works when it is healthy.

Advice on finding health care resources In the Appendix, we provide the names, addresses, phone numbers, and (when available) Internet addresses of the agencies and organizations that can help you with many different problems, particularly community support services.

Glossary A glossary defining various medical terms is found on p.1220.

On-line updates As a purchaser of this book, you will have access to a special Harvard Medical School site on the World Wide Web that will provide you with updated information. The Web site address appears at the bottom of the Index pages. The Web site contains:

New information since the book was published that the editors think is important

Additional color pictures beyond what could be included in the book

Interactive features that are not possible in a printed version of any book

Listing of the Harvard Medical School Newsletters, including sample content from recent issues and the ability to order the newsletters on-line This material will remain on the Web site until the publication of the book's second edition. At that time, a new Web site providing updated information to the second edition will be created.

Advice on dealing with the health care system Dealing with the health care system can be a pain in the neck. The many different kinds of health insurance policies and managed care programs can be very confusing. Also, doctors are under increased pressure to see more patients -- which means they have less time to spend with you.

Throughout this book, we provide information that will enable you to be your own advocate in obtaining the best health care. In Navigating the Health Care System, we specifically discuss managed care, health insurance, ways to get information about the quality of care in various health care systems, and the quality of care by doctors.

Having this book on a shelf in your home can help you stay healthy, cope with illness, and deal with the health care system, particularly the world of managed care. My colleagues and I have spent literally thousands of hours putting this book together. I have personally written or edited every word and the captions for every drawing or picture. For some of us, you might even call this book an obsession. Just ask my wife.

We wanted to give you the clearest, most current, and most complete information possible -- information you can use today, when you or a loved one is faced with a frightening symptom, a new diagnosis, or a recommendation to have a test or a treatment that may have risks as well as benefits. With this book, the other books that will follow, and our newsletters, we think we have done that; we hope that you agree.

Acknowledgments

Harvard Medical School More than 165 members of the Harvard Medical School faculty participated in the writing and editing of this book. I am enormously grateful to the associate editors who pulled together many of the book's chapters, as well as to the many contributing editors who gave generously of their time, experience, and wisdom.

My special thanks go to deans Daniel Tosteson, MD, and Joseph Martin, MD, PhD; executive deans David Bray and Paul Levy, and colleagues dean Daniel Moriarty, Elizabeth Allison, PhD, Robert Donin, and Cynthia Glott, without whom the Harvard Health Publications program would not have become a reality.

I must also thank my wife, Lydia Villa-Komaroff, and my colleagues at Harvard Medical School who, through observing my occasional absences from the normal activities of life, came to appreciate how editing a book of this size and complexity can become all-consuming. Thank you for your patience.

Simon & Schuster It was a great pleasure to work directly with Simon & Schuster and the Stonesong Press as the book was taking shape. I am especially grateful to Roslyn Siegel and William Rosen at Simon & Schuster for their ongoing support and superb editorial advice; to Paul Fargis, Ellen Scordato, Martin Lubin, and their colleagues at The Stonesong Press and Martin Lubin Graphic Design for their great skill in producing a beautiful-looking book; and to Robin Husayko for her remarkably careful and thoughtful copy-editing.

Finally, my eternal gratitude to editorial director Heidi Hough of Heidi Hough & Associates Inc, who worked tirelessly and skillfully to organize this enormous project, and to make sure that everything in it was clear and comprehensible. We couldn't have created this book without the help and involvement of everyone, especially Heidi Hough.

Anthony L. Komaroff, MD Editor in Chief Professor of Medicine, Harvard Medical School Editor in Chief, Harvard Health Publications Boston, Massachusetts September 1999

Copyright © 1999 Anthony L. Komaroff. All rights reserved.